It's
apparent that the prescribing of GP lenses is a well-kept secret. It's also evident
that too many new practitioners are hesitant to prescribe GPs for the majority of
patients who would benefit most from this corrective modality. Many patients benefit
from these lenses including astigmats, presbyopes, young progressive myopes, keratoconic
patients and post-surgical patients.

Those reluctant to prescribe GP lenses should
keep in mind one of the benefits of GP lenses: once fit into these lenses, patients
are unlikely to drop out of lens wear and your practice. The purpose of this article
is to provide pearls that we feel will even further optimize patient retention in
GP lenses.

Preventing GP Dropouts

Find the "Comfort Zone" If a GP wearer is going
to drop out, it often occurs within one month of dispensing. Therefore, it's extremely
important to explain adaptation to new GP wearers.

Certainly, new larger diameter lenses
with ultrathin profiles and aspheric peripheral curves optimize the probability
of achieving a lid attachment fitting relationship and of reducing the lid-lens
edge interaction. Advances in manufacturing technology have resulted in more consistent
edge quality and less initial comfort problems.

When explaining adaptation, it's important
to be realistic about discussing the initial lens awareness and how it simply pertains
to the lid interaction with the edge. Unless they're experiencing excessive awareness,
you can give most patients a rapid build-up schedule so that they're at full-time
wear in a matter of days. Using a topical anesthetic at the fitting visit, coupled
with a lens in their prescription, will help patients with the adaptation process.

Make Sure the Patient Masters Care
and Handling Patients should feel confident in the care and handling of their GP
lenses. We'd prefer that the staff member who provides this education is (or was)
a GP wearer. If not, he needs to be able to successfully teach patients proper lens
handling while also reassuring them that their lenses will be comfortable once the
lids have adapted.

Emphasize that GP Lenses Aren't a Commodity
You need to separate the fitter and the supplier in the mind of the patient. Emphasize
to patients that their GP lenses can never be a commodity because they're custom
fit, and that GP lenses are designed specifically to match their corneal and refractive
configuration.

Inform Patients of the GP Benefits
It's important for patients to be aware of the pot of gold at the end of the adaptational
rainbow. This modality is very healthy, provides good vision and is quite durable.
For the presbyope (satisfactory vision at all distances) and the corneal reshaping
patient (good unaided vision), these benefits are even more life changing.

Regular Replacement Certainly a method
to ensure that patients return to the practice on a regular basis and are less likely
to drop out or pursue another practitioner is to fit them into hyper-Dk lenses with
an annual replacement program.

Offer In-office Services to Optimize
Lens Performance You can encourage patients to return every six months for an evaluation.
At those visits you can polish the lenses (surface and/or edge) to optimize surface
wettability and comfort as a service from their prescribing practitioner.

Resist the Temptation to Refit It's
not uncommon for satisfied and successful GP contact lens wearers to inquire about
soft contact lenses (opaque, disposable, continuous wear, etc.). Unless your patients
are adamant, resist this temptation. It can often result in a patient who's not
as satisfied with his quality of vision.

Refitting also may result in a patient
who doesn't return to his prescribing practitioner for replacement contact lenses.

The Impact of the FCLCA

In our opinion, the Fairness to Contact Lens Consumers
Act (FCLCA) has had little impact with our GP-wearing patients. GP patients virtually
never go to alternate sources. In one case, one patient received his GP lenses from
another practitioner; when the lenses weren't quite right and the co-author (BG)
refused to modify them or become involved with the vendor, the patient came back
to BG for his GP needs.

The FCLCA presents an opportunity for practitioners
who routinely fit GP lenses. Because most of the patients who've used their prescription
to obtain their lenses elsewhere are soft lens patients, this presents an opportunity
to fit new contact lens wearers with GP lenses.

You can educate your patients that
the GP lens parameters can't be duplicated unless the same laboratory you use is
also used by the alternate supplier because blends and edge contours differ among
laboratories.

Prescribing GP lenses also lessens
the burden on the office staff as some of the automated phone systems continuously
call our offices with computer messages desiring patient information that isn't
always available. In some cases, the patients they're referring to aren't even in
our practices any longer but the computers from various distributors continue calling,
tying up our phone lines and wasting valuable staff time.

Summary

It's evident that satisfied GP wearers are unlikely
to drop out of lens wear and likely to return to their prescribing practitioner
for follow-up care and replacement lenses. This is certainly a modality that we
feel represents a great opportunity for patient satisfaction and practice growth.

Dr.
Davis is a Diplomate of the Cornea and Contact Lens Section of the American Academy
of Optometry.

Dr. Giedd practices in Florida. He is a contributor to the GP
Lens Institute.

Dr. Eiden is a committee chairperson of the American Optometric
Association's Contact Lens and Cornea Section.

Dr. Resnick is a Diplomate in the Cornea and Contact Lens section
of the American Academy of Optometry.

Dr. Ames is in private group practice and served on the clinical
faculty at the University of Waterloo School of Optometry, Ontario, Canada.

Dr. Bennett is Director, Student Services, Co-Chief, Contact
Lens Service at the University of Missouri-St. Louis College of Optometry and the
Executive Director of the GP Lens Institute.